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Upper Sandusky


Exempted Village Schools

Upper Sandusky Exempted Village Schools News Article

Bussing Alternative Stop Form

Alternative Stop Form

UPPER SANDUSKY SCHOOLS

TRANSPORTATION DEPARTMENT


This form is for use when you are requesting an alternative stop location for your child.

As a safety consideration for your child it is important that the Transportation Department have current information.  Medical and designated place of safety forms must be on file.

This form must be filled out every school year and returned to the Bus Garage 72 hours in advance.


I AM REQUESTING THAT THE FOLLOWING STUDENT BE TRANSPORTED TO/FROM AN ALTERNATIVE ADDRESS:


STUDENT NAME _________________________________ SCHOOL____________


HOME ADDRESS________________________________________ GRADE_______


ALTERNATIVE RESIDENCE NAME______________________________________


ALTERNATIVE ADDRESS ______________________________________________


ALTERNATIVE PHONE_________________EMERGENCY PHONE____________


DAYS OF WEEK:  MON_____ TUES_____WED_____THURS_____FRID_____


            AM_____    PM_____    BOTH_____


DATES TRANSPORTATION REQUESTED:  FROM____________ TO___________



PARENT/GUARDIAN SIGNATURE________________________________________


THIS REQUEST WILL BE APPROVED IF THE ALTERNATIVE STOP IS ON A BUS RUN AND THE STOP WILL BE CONSISTENT AND SPACE IS AVAILABLE.

 



THIS SECTION FOR COMPLETION BY THE TRANSPORTATION DEPARTMENT


REGULAR BUS NUMBER ASSIGNED        AM _____    PM _____


ALTERNATIVE BUS NUMBER ASSIGNED    AM _____    PM _____



APPROVED BY: __________________________________   DATE _______________


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